NPI | 1003095795 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 089948) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 114361) |
Enumeration Date | 2007-10-30 |
Last Update Date | 2022-11-04 |